Fungal infections of the toenails

The tablets often need to be prescribed in divided doses to be taken more than once a day, and compliance can become difficult for some patients...

Question

As an elderly male, I have fungal infections with distortion of my toenails.

I have heard that I would have to take treatment for about two years to eradicate this. Is this true, sensible or worthwhile for what is really a cosmetic problem?

Answer

The conventional oral treatment of fungal nail infections can take as long as two years to bring about a successful cure.

This is because the treatment, eg Griseofulvin, halts the growth of the fungus present, allowing a new nail to come up in its own time.

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In order to be successful, the course of treatment has to go on for as long as there is still some infected nail present, and this time is variable, depending upon the severity of the infection and rate of nail growth.

The tablets often need to be prescribed in divided doses to be taken more than once a day and compliance can become difficult for some patients over such a long period of time, leading to prolonged or failed treatment.

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Newer treatment has been available now, eg Terbinafine, for some years that kills the fungal infection and therefore can be taken for a shorter period of time to effect a cure.

This is usually between three and six months for toenail infections on a once daily basis.

Although one could say that the problem is purely a cosmetic one, fungal toenail infections can cause significant difficulty with mobility, particularly if they compound other coexisting problems.

It is therefore often the older patient who has most to gain from treatment and depending on the circumstances I would generally look in favour on treating the condition.

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